Dubious space for Artelon joint resurfacing for basal thumb (trapeziometacarpal joint) osteoarthritis. A systematic review

Abstract

Several prosthetic implants show promising results in terms of pain relief and functional request, but there is a need of long-term randomized controlled trials to demonstrate their equivalence, and eventually superiority, compared to standard techniques.

Comparison of arthrodesis and arthroplasty of Chinese thumb carpometacarpal osteoarthritis

“…An elastic silicone prosthetic implant is currently rarely used in thumb CMC joint replacement due to reactive synovitis and prosthetic wear [10]. The use of Artelon implant is not recommended because of its high revision rate and worse outcomes compared with conventional techniques [11]. Similarly, spherical polymer implant failures have been reported [12].…”

Early Cup Loosening After Metal-on-Metal Total Joint Replacement of the Trapeziometacarpal Joint: A Retrieval Study

“…However, high rates of synovitis with aggressive bone destruction have been reported (Lanzetta and Foucher, 1995) and the implant has fallen out of favour for this patient group. Another product that was popularized in the early 2000's was the Artelon® spacer (Ehrl and Erne, 2015;Smeraglia et al, 2018), a synthetic Tshaped spacer that was secured in place between the metacarpal and trapezium, or even between the scaphoid and trapezium (if used for STT arthritis). After some years of use, many publications have warned against a high rate of complications (mostly foreign body reactions) and it has also fallen out of favour.…”

The Turkish League Against Rheumatism Recommendations for the Management of Hand Osteoarthritis Under Guidance of the Current Literature and 2018 European League Against Rheumatism Recommendations

“…Arthrodesis (for DIP joints), arthrodesis or arthroplasty (for PIP joints), arthroplasty (for MCP joints), trapeziectomy+LRTI, arthroplasty or arthroscopic partial trapeziectomy (for first CMC joint) may be considered". We would like to explain the type of surgical methods because of the importance of stability (mainly for first CMC and DIP joints) and need for mobility (mainly for MCP and PIP joints) concerns in different joints reported recently [20][21][22] and to emphasize the role of postoperative rehabilitation. 48 Thus, we added the sentence about hand rehabilitation as follows: "Rehabilitation programs following first CMC arthroplasty are efficient and safe in pain relief and improvement of function and grip strength".…”

“…New studies have also been published with good results about total first CMC arthroplasty, trapeziectomy, LRTI, total endoprosthesis, and resurfacing arthroplasty for thumb base OA and silicone MCP arthroplasty for MCP OA, after the publication of the systematic review of 2018 EULAR hand OA management guideline. [20][21][22] We added the sentence about postoperative rehabilitation, taking the recently published systematic review into consideration: 47 "Early active mobilization following first CMC arthroplasty are efficient and safe in pain relief and improvement of function and grip strength". Although there was no statistical difference between the level of agreement values of original and revised items, the revised item was accepted.…”

“…20 Furthermore, two systematic reviews about splinting and surgery in thumb base OA have also been published recently. 21,22 Management recommendation guidelines are systematically developed statements to assist clinicians in appropriate healthcare decisions for specific clinical conditions. 23 Each country has genetic, socioeconomic and cultural differences.…”